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How to Substantiate Benefits Card Transactions

Why Will Marin Benefits Ask Me For Documentation?

Marin Benefits may, in accordance with IRS guidelines, request documentation for your Marin Benefits Debit MasterCard® transactions to confirm that services were eligible under your employer's benefit Plan. While your provider has been paid, these transactions are pending substantiation and will require you to submit documentation to be fully approved. 

 

What Documentation Am I Required to Submit?

When documentation is required, you will receive a request from Marin Benefits asking you to provide either your Explanation of Benefits (EOB) from your insurance carrier or an itemized statement from your provider. To resolve a pending transaction, the documents you submit must include:

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How Do I Submit My Documentation?

Please include a copy of the substantiation request with your documentation and submit to Marin Benefits through any of the methods below:

  1. Name of the service provider

  2. Name of the patient

  3. Description of the services billed or items purchased

  4. Service date(s)

  5. Amount(s) billed

Please note that credit card signature slips and bank statements are not acceptable forms of documentation. 

Online

Email

Fax

Mail

marinbenefits.com
claims@marinbenefits.com
415-454-2928
Marin Benefits Administrators
6366 Commerce Blvd, Suite 293 
Rohnert Park, CA 94928

​​Important to Know About Letters of Medical Necessity and Eligibility

A Letter of Medical Necessity (LMN) does not determine whether an expense is eligible under your benefit. Eligibility is defined by your employer’s benefit plan, not by a medical provider, and this benefit is not the same as a general-purpose FSA or HSA. As a result, eligible expenses may be more limited. While an LMN may be required to support certain claims, it does not automatically make a service eligible or override plan rules. To understand what expenses are covered, review your Plan Summary in the member portal.

Update your Pending transactions through the Member Portal

If you haven’t signed up on the Member Portal you will need to register before you can upload your documents. Registration instructions are on your Benefit Summary. To upload your documentation, please click the Pending transaction under My Recent Transactions on your Personal Dashboard and select Add Receipt.

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Why Can’t Marin Benefits Contact My Insurance Provider For Me?

Marin Benefits is an independent Third Party Administrator (TPA). We are not affiliated with your insurance company or provider and are unable to obtain your claim information on your behalf in accordance with HIPAA Privacy Laws.

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What Happens If I Do Not Substantiate My Transactions When Requested?

Marin Benefits will make multiple attempts to contact you regarding pending transactions. Pending transactions which remain unresolved, or where documents provided indicate the transaction was not an eligible expense, will be reclassified as Ineligible. Ineligible transactions must be refunded back to your benefit account or your benefits debit card will be suspended.

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How Do I Refund My Benefit Account?

There are two (2) ways to refund your benefit account: 

  • Members who have enrolled for Direct Deposit can submit a refund to their benefit account directly from their bank account through the Balance Due notification at the top of their Member Dashboard.




     

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  • By mailing a refund check along with a copy of the ineligible transaction notice:

Marin Benefits Administrators

Attention: Member Refunds

6366 Commerce Blvd, Suite 293

Rohnert Park, CA 94928

Please note that Marin Benefits cannot accept HRA refunds via credit card.

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